Centralisation of extremely preterm births and decreased early postnatal mortality in Sweden, 2004-2007 versus 2014-2016.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-09-23 DOI:10.1111/apa.17429

Christian Gadsbøll, Lars J Björklund, Mikael Norman, Thomas Abrahamsson, Magnus Domellöf, Anders Elfvin, Aijaz Farooqi, Lena Hellström-Westas, Stellan Håkansson, Karin Källén, Erik Normann, Fredrik Serenius, Karin Sävman, Petra Um-Bergström, Ulrika Ådén, David Ley

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引用次数: 0

Abstract

Aim: We evaluated the increased centralisation of extremely preterm (EPT) births in Sweden in relation to the changes in mortality and morbidity.

Methods: Population-based data covering Swedish live births from 22 + 0 to 26 + 6 weeks of gestation during 2004-2007 and 2014-2016 were analysed for associations between time-period, birth within (inborn) or outside (outborn) regional centres, and outcomes.

Results: Among 1626 liveborn infants, 703 were born in 2004-2007 and 923 in 2014-2016. Birth outside (vs. within) regional centres was associated with a higher infant mortality even after adjustment for birth cohort, gestational age, birthweight standard deviation score and infant sex (adjusted odds ratio 2.01, 95% confidence interval 1.31-3.07, p = 0.001). The higher 1-year mortality in outborn infants was mainly due to more deaths within 24 h after birth. Outborn infants had a higher incidence of intraventricular haemorrhage grade 3-4 than inborn infants (22% vs. 14% in 2004-2007, and 22% vs. 13% in 2014-2016, both p < 0.05). While survival to 1 year without major morbidity increased in inborn infants (33%-40%, p = 0.008), it remained unchanged in outborn infants (29% vs. 30%, p = 0.88).

Conclusion: Centralisation of EPT births contributed to a lower 1-year mortality in 2014-2016 than that in 2004-2007, attributed to a decrease in deaths before 24 h among inborn infants.

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2004-2007年与2014-2016年瑞典极早产儿的集中管理和产后早期死亡率的下降。

目的：我们评估了瑞典极早产（EPT）集中化程度的提高与死亡率和发病率变化的关系：方法：对2004-2007年和2014-2016年期间妊娠22+0周至26+6周的瑞典活产婴儿的人口数据进行分析，以确定时间段、在地区中心内出生（内生）或在地区中心外出生（外生）与结果之间的关联：在1626名活产婴儿中，有703名出生于2004-2007年，923名出生于2014-2016年。即使对出生队列、胎龄、出生体重标准偏差评分和婴儿性别进行调整后，在地区中心外（与在地区中心内）出生的婴儿死亡率仍较高（调整后的几率比为 2.01，95% 置信区间为 1.31-3.07，P = 0.001）。外生儿 1 年死亡率较高的主要原因是出生后 24 小时内死亡的人数较多。外生儿脑室内出血 3-4 级的发生率高于内生儿（2004-2007 年为 22% 对 14%，2014-2016 年为 22% 对 13%，均为 p 结论：外生儿脑室内出血 3-4 级的发生率高于内生儿（2004-2007 年为 22% 对 14%，2014-2016 年为 22% 对 13%，均为 p）：与2004-2007年相比，2014-2016年EPT分娩的集中化降低了1年死亡率，这归因于出生婴儿中24小时前死亡的人数有所减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464